Provider First Line Business Practice Location Address:
9200 W. WISCONSIN AVE.
Provider Second Line Business Practice Location Address:
FROEDTERT HOSPITAL
Provider Business Practice Location Address City Name:
MILWAUKEE
Provider Business Practice Location Address State Name:
WI
Provider Business Practice Location Address Postal Code:
53226
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
414-805-7780
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
06/14/2016